Director's Report to the National Advisory Council on Drug Abuse - May, 2005

Research Findings - Prevention Ressearch

Predicting Early Adolescent Gang Involvement from Middle School Adaptation

This study examined the role of adaptation in the first year of middle school (Grade 6, age 11) to affiliation with gangs by the last year of middle school (Grade 8, age 13). The sample consisted of 714 European American (EA) and African American (AA) boys and girls. Specifically, academic grades, reports of antisocial behavior and peer relations in 6th grade were used to predict gang involvement by 8th grade, measured through self-, peer, teacher, and counselor reports. Unexpectedly, self-report measures of gang involvement did not correlate highly with peer and school staff reports. The results, however, were similar for other and self-report measures of gang involvement. Analysis of means revealed statistically reliable differences in 8th-grade gang involvement as a function of the youth gender and ethnicity. Structural equation prediction models revealed that peer nominations of rejection, acceptance, academic failure, and antisocial behavior were predictive of gang involvement for most youth. These findings suggest that the youth level of problem behavior and the school ecology (e.g., peer rejection, school failure) require attention in the design of interventions to prevent the formation of gangs among high-risk young adolescents. Dishion, T.J., Nelson, S.E. and Yasui, M. Journal of Clinical Child and Adolescent Psychology 34(1), pp. 62-73, 2005.

This study examined how self-reported maternal stress and distress are associated with child disruptive behaviors, based on mother and teacher ratings of child disruptive behavior problems (attention problems, aggression, and delinquency) collected for 215 boys between 9 and 12 years of age. Participating mothers also provided self-report data on socioeconomic status (SES), parenting stress, and distress (depression and anxiety/somatization). Low SES was significantly associated with both mother- and teacher-reported child disruptive behavior problems. In addition, the relation between parenting stress and mother-reported child disruptive behavior problems was found when SES was controlled. A significant relation between maternal distress and mother-reported child disruptive behavior problems (particularly attention problems), also was observed when both SES and parenting stress were controlled. Maternal stress and distress were not significantly related to teacher-reported child disruptive behavior problems. Although the lack of an association between teacher-reported behavior problems and maternal stress and distress might be interpreted as a rater bias by these mothers, it may be that the mothers' symptoms are associated with a stressful home environment, thus exacerbating child disruptive behavior problems and eventually leading to a reciprocal relation between symptomatology in mothers and children. Barry, T.D., Dunlap, S.T., Cotton, S.J., Lochman, J.E. and Wells, K.C. The Influence of Maternal Stress and Distress on Disruptive Behavior Problems in Boys. Journal of the American Academy of Child and Adolescent Psychiatry 44(3), pp. 265-273, 2005.

The Influence of Partner Type and Risk Status on the Sexual Behavior of Young HIV+ Men who have Sex with Men

Partner type (primary/regular vs. single-time or casual) and risk status (HIV+, HIV- but IV drug use, HIV- and low risk) each affect the sexual behavior of young men living with HIV (YMLH) who have sex with men but the interaction of these risk factors on sexual risk behavior is not know. This study assessed the sexual behavior and sexual partner characteristics of 217 YMLH recruited from adolescent care clinics in 4 AIDS epicenters. Using generalized linear modeling the authors analyzed the effect of partner type and partner risk status on unprotected sex acts. Sixty-two percent of YMLH reported multiple partners, 26% reported 1 sexual partner, and 12% reported abstinence in the past 3 months. Approximately 34% of polygamous and 28% of monogamous youth engaged in unprotected sex. Monogamous youth were most likely to have unprotected sex with HIV-positive partners. Polygamous youth were most likely to have unprotected sex with HIV-positive partners, irrespective of whether the partner was regular or casual. For polygamous YMLH unprotected sex did not differ among single-time/new partners with different risk levels, suggesting that partner characteristics and perception of their partner's risk influence the condom use behavior of YMLH. These findings suggest that partner characteristics influence the condom use behavior of YMLH. These young men are practicing safer sex with partners who they do not want to infect and not using condoms with partners with whom transmission risk is less concerning. However, it is questionable whether the youth can truly know a partner's risk or HIV status and these young men are still at significant risk for infection with an STD. Preventive interventions must include skills for acquiring accurate information about partner risk status and education regarding the health risks of unprotected sex with HIV seroconcordant partners. Lightfoot, M., Song, J., Rotheram-Borus, M.J. and Newman, P. The Influence of Partner Type and Risk Status on the Sexual Behavior of Young Men who have Sex with Men Living with HIV/AIDS. JAIDS-Journal of Acquired Immune Deficiency Syndromes 38(1), pp. 61-68, 2005.

Prospective Prediction of Alternative High School Graduation Status at Emerging Adulthood

Most studies that examine the prediction of graduation status among teens have examined those who attend regular high schools. This study reports the prediction of high school graduation status five years later among 646 youth who attended alternative (continuation) high schools at baseline. Those youth at baseline who: (a) reported less intention to use cigarettes, alcohol, or marijuana during the next year; (b) suffered relatively few drug-related consequences during the last year; (c) were relatively less likely to have carried a weapon (knife or gun) in the last year; (d) reported feeling relatively hopeful about the future; and (e) were more likely to self-report having graduated continuation high school 5 years later. These results suggest that the consequences of drug use, not drug use per se, other illegal behavior, and a sense of well-being are important predictors of graduation among groups of high-risk teens. Sussman, S., Rohrbach, L.A., Skara, S. and Dent, C.W. Prospective Prediction of Alternative High School Graduation Status at Emerging Adulthood. Journal of Applied Social Psychology 34(12), pp. 2452-2468, 2004.

Tobacco and Alcohol Use as an Explanation for the Association between Externalizing Behavior and Illicit Drug Use among Delinquent Adolescents

Substance use among adolescents is frequently comorbid with other psychiatric disorders. Most studies of these comorbidities use samples of middle or high school students or draw from inpatient settings. Less is known about substance use and psychiatric comorbidity among delinquent adolescents. The present study examined data from two cohorts of juvenile offenders collected over a 2-year period (n=245, n=299). Participants reported frequency of cigarette, alcohol, marijuana, and other substance use. Participants' parents completed a measure of behavior problems. Path analyses suggested that parental reports of externalizing problems were significantly related to self-reported substance use while parental reports of internalizing problems were not. These findings suggest that smoking and alcohol use act as mediators between externalizing problems and marijuana and other drug use. Although there were some mean differences by gender, the pattern of relationships among the variables did not differ by gender. Helstrom, A., Bryan, A., Hutchison, K.E., Riggs, P.D. and Blechman, E.A. Tobacco and Alcohol Use as an Explanation for the Association between Externalizing Behavior and Illicit Drug Use among Delinquent Adolescents. Prevention Science 5(4), pp. 267-277, 2004.

Vulnerability of Children of Incarcerated Addict Mothers: Implications for Preventive Intervention

This preliminary report examined the characteristics, experiences, and behavior of 88 primarily African-American adolescents with incarcerated addict mothers. The age, gender, and risk factor profiles with the children's adjustment status, based on self-reported questionnaire information and selected personality/behavioral assessment inventories, indicated that in spite of the incarceration of their substance-abusing mothers, the majority of these children were neither especially deviant nor maladjusted. All but a small percentage had successfully avoided substance abuse and the adoption of a deviant lifestyle at this point in their development. In most cases, mother surrogates (usually a grandmother or other family member) had functioned as primary caregivers of the children for many years prior to the incarceration of their birth mothers, possibly attenuating the negative impact ordinarily associated with a mother's absence from the home. However, there was a general indication of problematic school behavior and vulnerability to deviant peer influences that should be addressed in efforts aimed at preventing the escalation of deviant activity in such children. In almost all cases the child's caregiver needed caseworker support services. Hanlon, T.E., Blatchley, R.J., Bennett-Sears, T., O'Grady, K.E., Rose, M. and Callaman, J.M. Vulnerability of Children of Incarcerated Addict Mothers: Implications for Preventive Intervention. Children and Youth Services Review 27(1), pp. 67-84, 2005.

The Characteristics and Vulnerability of Incarcerated Drug-Abusing Mothers

Although the number of drug-addicted incarcerated mothers has grown substantially in recent years, there is little information on their unique characteristics and vulnerabilities. This study examined data on 167 incarcerated drug-abusing mothers from Baltimore City who had volunteered for a parenting program offered at a Maryland correctional facility. Prior to entering this program, these mothers completed a battery of assessment measures including an extensive interview covering their early developmental and current experiences and standardized tests of psychological adjustment and parenting satisfaction. Analyses of these data focused on the link between risk/protective factors drawn from the early development experiences of these and their current adjustment status. There were significant relationships between higher risk levels and less favorable current adjustment suggesting the need to develop both prevention and clinical intervention efforts targeting both mothers and their children. Hanlon, T.E., O'Grady, K.E., Bennett-Sears, T. and Callaman, J.M. Incarcerated Drug-Abusing Mothers: Their Characteristics and Vulnerability. American Journal Of Drug And Alcohol Abuse 31(1), pp. 59-77, 2005.

Sensation Seeking Contributes Directly and Indirectly to Adolescent Drug Use

This study sought to examine whether sensation seeking contributes to the likelihood of drug use by adolescents both directly as well as indirectly through the way it shapes social interactions with peers in the context of drug use. In addition, it examined whether other risk or protective factors affect the likelihood of adolescent drug use by influencing either sensation seeking, association with deviant peers or frequent pro-drug discussions with peers. The analysis was based on cross-sectional data from youth 12 to 18 (N=5,141) collected as part of the evaluation of the National Youth Anti-Drug Media Campaign. The findings support the study's hypotheses that sensation seeking had a significant correlation with association with deviant peers, frequency of pro-drug discussions and intention to use marijuana. Association with deviant peers was also significantly correlated with frequent pro-drug discussions with peers and intention to use marijuana. A hierarchical regression analysis of the contribution of sensation seeking, the frequency of association with peers and pro-drug discussions to intention to use marijuana as well as other risk and protective factors strongly supported the hypothesis that all three contribute independently to intention to use marijuana and that additional risk and protective factors also affected intentions. In the models sensation seeking alone accounted for between a third and a half of the explained variance in the dependent variables suggesting its importance in understanding adolescent drug use. In addition, different factors may protect high sensation-seeking adolescents from using drugs or engaging in such activities as associating with deviant peers which in turn increases their risk for drug use. These findings suggest the importance of studying both direct and indirect influences of variables on drug use and clarifying the links among these factors. Yanovitzky, I. Sensation Seeking and Adolescent Drug Use: The Mediating Role of Association with Deviant Peers and Pro-drug Discussions. Health Communication 17(1), pp. 67-89, 2005.

New Measure of Positivity Offset and Negativity Bias Relates to Sensation Seeking Substance Use

This article investigates links among motivation, sensation seeking, and substance use by extending conceptualizations of sensation seeking as a function of resting activation in the appetitive and aversive motivational systems. The goal was to develop a measure of positivity offset and negativity bias. Positivity offset is the degree to which the appetitive system is more active than the aversive system in a neutral environment. Negativity bias is the speed with which the aversive system responds to negative stimuli of increasing intensity. Four types of individuals would include those with a large positivity offset and a small negativity bias, called risk takers; those with a large positivity offset and a large negativity bias, called coactives; those with a small positivity offset and a small negativity bias, called inactives; and those with a small positivity offset and a large negativity bias, called risk avoiders. Participants (64 college students of average age 20), viewed and rated a series of pictures ranging in valence and arousal and completed questionnaires assessing sensation seeking and substance use. These new measures had reasonable intercorrelations and correlated with sensation seeking and substance use. Although both positivity offset and negativity bias were related to sensation seeking, substance use was primarily related to positivity offset. Hierarchical regression analyses showed that positivity offset and negativity bias can predict significant variance in substance use, and the variance explained by these measures is different than that explained by sensation seeking alone. Risk takers did indeed score high on sensation seeking and were high substance users. Risk avoiders scored very low on sensation seeking and were low substance users. The coactives and inactives were in the middle. Measures of positivity offset and negativity bias may allow us to define the motivation type most likely to experiment with and become substance users. Lang, A., Shin, M. and Lee, S. Sensation Seeking, Motivation, and Substance Use: A Dual System Approach. Media Psychology, 7, pp. 1-29, 2005.

Sexual and substance use behaviors co-vary in adolescence. There also are racial and gender differences in the prevalence of HIV and other sexually transmitted diseases (STDs). These differences in subgroup risk behavior differences have not been systematically investigated with nationally representative data. Using cluster analysis 13,998 non-Hispanic black and white participants in the National Longitudinal Study of Adolescent Health, Wave 1, were grouped according to self-reported substance use and sexual behavior. Multinomial logit analyses examined racial and gender differences by cluster. Among 16 clusters, the two defined by the lowest risk behaviors (sexual abstinence and little or no substance use) comprised 47% of adolescents; fewer than 1% in these groups reported ever having received an STD diagnosis. The next largest cluster-characterized by sexual activity (on average, with one lifetime partner) and infrequent substance use-contained 15% of participants but nearly one-third of adolescent with STDs. Blacks were more likely than whites to be in this group. Black males also were more likely than white males to be in three small clusters characterized by high-risk sexual behaviors (i.e., having had sex with a male or with at least 14 partners, or for drugs or money). Although Black females generally were the least likely to be in high-risk behavior clusters, they were most likely to report STDs. Thus, adolescents' risk behavior patterns vary by race and gender, and do not necessarily correlate with their STD prevalence. Halpern, C.T., Hallfors, D., Bauer, D.J., Iritani, B., Waller, M.W. and Cho, H. Implications of Racial and Gender Differences in Patterns of Adolescent Risk Behavior for HIV and Other Sexually Transmitted Diseases. Perspectives on Sexual and Reproductive Health 36(6), pp. 239-247, 2004.

Development of a Life Skills Curriculum for Young South African Adults

This article describes the development of an international collaborative effort designed to reduce risky behavior (e.g., substance use, risky sexual behavior) and its consequences (e.g., HIV/AIDS, pregnancy, and addictions) among a sample of South African youth. Because many of these risky behaviors occur in free time, a major part of the effort was leisure education to promote positive use of free time. The HealthWise program described here was pilot tested and is currently underway as a larger-scale, randomized trial in the Province of the Western Cape in South Africa. The article explains how the HealthWise curriculum was conceptualized revised, in close collaboration with the Western Cape Education Department, and how the on-going randomized trial was implemented. Caldwell, L.L., Smith, E., Wegner, L., Vergnani, T., Mpofu, E., Flisher, A. and Matthews, C. HealthWise South Africa: Development of a Life Skills Curriculum for Young Adults. World Leisure Journal, 46(3), pp. 4-17, 2004.

Development and Validation of a Gender-Balanced Measure of Aggression-Relevant Social Cognition

This study examined the psychometric properties of the Social-Cognitive Assessment Profile (SCAP), a gender-balanced measure of social information processing (SIP) in a sample of 371 (139 girls, 232 boys) 2nd- to 4th-grade children. The SCAP assesses 4 dimensions of SIP (Inferring Hostile Intent, Constructing Hostile Goals, Generating Aggressive Solutions, and Anticipating Positive Outcomes for Aggression) in the context of peer conflict involving relational and overt provocation. Confirmatory factor analyses indicated that the 4 latent factors provided a good fit to the data for girls and boys and for African American and non-African American children. Regression analyses in which teacher and peer evaluations of aggression and peer evaluations of social competencies were regressed on each of the 4 SCAP scales supported the test's convergent and discriminant validity. These results suggest that the SCAP is an easily administered and brief measure of SIP that is appropriate for racially diverse populations of elementary boys and girls. Hughes, J.N., Meehan, B.T., and Cavell, T.A. Journal of Clinical Child and Adolescent Psychology 33(2), pp. 292-302, 2004.

Exposure to PTSD in the General Population after Mass Terrorist Incidents

Several epidemiological studies were conducted in the aftermath of the September 11th attacks that made use of standardized assessment measures to allow comparability across studies that included design variations permitting comparison of different segments of the US and New Your City area populations. These studies found elevated prevalence of PTSD in the general population in the first months after the attacks. In New York City post-traumatic stress was similar among those who were and those who were not directly exposed to the attacks. Debate about the exact array of symptoms that constitute PTSD and whether that diagnosis is best characterized as a categorical or dimensional variable continue. The general population data suggest that it is likely that a wide range of experiences beyond those currently considered extreme traumatic events by DSM-IV are capable of producing PTSD symptoms. Galea, S. and Resnick, H. Posttraumatic Stress Disorder in the General Population After Mass Terrorist Incidents; Considerations about the Nature of Exposure. CNS Spectrums 10(2), pp. 107-115, 2005.

TV Watching and Mental Health in the General New York City Population after 911

The September 11, 2001 terrorist attacks were watched on television by millions. Using data from a telephone survey of New York City residents in January 2002 (N=2001), this study explored the relationships between TV watching and probably posttraumatic stress disorder (PTSD) after the attacks. Among persons directly affected by the attacks or those who had prior traumatic experiences, watching television was associated with probably PTSD. Experiencing a peri-event panic reaction accounted for some of the association between TV watching and probably PTSD. In this era of constant TV news coverage of global events, the potential impact of watching disasters, wars, terrorism and other traumatic events on television is a growing concern requiring research on the mechanisms behind the observed associations between TV watching and posttraumatic stress to better prepare for the effects of future disasters. Ahern, J. Galea, S., Resnick, H. and Vlahov, D. Television Watching and Mental Health in the General Population of New York City After September 11. Journal of Aggression, Maltreatment and Trauma, 9(1/2), pp. 109-124, 2004.

Intervention Implications of a Theory-Based Understanding of Marijuana Use Intentions

Using an integrated model of behavior change (Fishbein et al. 2001), the authors predict intentions to use marijuana occasionally and regularly in a national sample of youth 12-18 (N=600) and delineate choices in intervention foci and message selection. Predictors include psychosocial and structural factors such as beliefs about consequences of marijuana use, attitudes, norms and self-efficacy. Respondents were recruited at 18 malls and completed anonymous touch-screen surveys on a desktop computer. Respondents who reported never using marijuana answered questions either about occasional or regular use; prior users were assigned to the set of questions about regular use. Respondents who had never used marijuana expressed strong intentions to avoid use in the future; prior users were significantly more likely to intend future use. This suggests that planners must assess whether to use limited resources to focus on the former group. For both occasional and regular use, youths' own attitudes toward marijuana use are stronger predictors of their intentions than norms or self-efficacy. This suggests that attitude and its underlying beliefs should be the focal point of interventions with a focus on norm perception a secondary concern. Examination of the relationship of outcome expectancies and attitudes can help to identify priorities for targeting particular beliefs and attitudes on which there is variation and where beliefs may plausibly be changed. Sayeed, S., Fishbein, M., Hornik, R., Cappella, J. and Ahern, R.K. Adolescent Marijuana Use Intentions: Using Theory to Plan an Intervention. Drugs, Education, Prevention & Policy 12(1), pp. 19-34, 2005.

Correlates of HIV Status among Injection Drug Users in a Border Region of Southern China and Northern Vietnam

This article examines the correlates of HIV status among samples of injection drug users (IDUs) in Lang Son Province, Vietnam (n = 348), and Nina Ming County, Guangxi Province, China (n = 294), who were interviewed and tested for HIV antibody just before the start of a peer-based HIV prevention intervention in this border region. Participants were largely male, in their 20s, and single. Logistic regression analysis suggests that among Chinese IDUs, border-related factors (e.g., living closer to the border, buying drugs across the border more frequently) and younger age are the best predictors of HIV positivity. In Vietnam, HIV status seems to drive behavior (e.g., some risk reduction practices are predictive of HIV positivity). These differing patterns may reflect the fact that the intertwined epidemics of heroin injection and HIV began earlier and HIV prevalence has reached significantly higher levels in Lang Son than across the border in Ning Ming. Although border-related factors emerge as predictors in Ning Ming, more IDUs in Lang Son are HIV-positive and may be reacting behaviorally to that status. Their greater likelihood of engaging in risk reduction measures may reflect some combination of a belief that risk reduction can slow disease progression and an altruistic desire to avoid infecting others. Hammett, T.M., Johnston, P., Kling, R., Liu, W., Ngu, D., Tung, N.D., Binh, K.T., Dong, H.V., Hoang, T.V., Van, L.K., Donghua, M., Chen, Y., and Jarlais, D.C.D. Correlates of HIV Status among Injection Drug Users in a Border Region of Southern China and Northern Vietnam. JAIDS-Journal of Acquired Immune Deficiency Syndromes 38(2), pp. 228-235, 2005.

Cigarette Smoking More Prevalent and More Frequent Among Whites

Studies of adolescents consistently show that smoking prevalence rates are higher for Whites than for African-Americans. Yet, while White adults report a higher prevalence of lifetime smoking, African-American adults report a higher prevalence of current smoking. Moreover, African-American adults seem to experience higher rates of smoking-related health problems, especially lung cancer. These contradictory findings have been explained by the fact that African-Americans begin smoking later, have lower cessation rates, and smoke higher tar yield brands than Whites. However, many of the common assumptions about cigarette use, such as that most adult smokers report their first use during childhood or adolescence have been based on samples comprised primarily of Whites and may not be generalizable to African-Americans. This study examined racial differences in onset, prevalence and developmental trajectories of cigarette smoking from childhood into young adulthood using the Pittsburgh Youth Study, a prospective, longitudinal study of 562 African American and 421 White high-risk males. Three trajectory groups emerged for both races: nonsmokers, light/occasionally smokers, and heavy/regular smokers. Significantly more Whites were in the heavy/regular smoker group and more African-Americans were in the nonsmoker group. White heavy/regular smokers began smoking earlier and reached higher mean quantities of cigarettes per day. Race remained a significant predictor of cigarette use even after controls for socioeconomic status. White, H.R., Nagin, D., Replogle, E. and Stouthamer-Loeber, M. Racial Differences in Trajectories of Cigarette Use. Drug and Alcohol Dependence 76, pp. 219-227, 2004.

Drug Use may be Mediated through Low Hostile Anger Control

The relationships among selected predictors of violence, including victimization, low conflict management efficacy, hostile anger and drug use were examined using data on 8th-, 10th-, and 12th-grade adolescents. The secondary analysis used population-based, cross-sectional survey of health behaviors (N = 3922). For each grade cohort, it was hypothesized that victimization and low conflict management efficacy would predict low hostile anger control, which would predict gateway drug use, and the subsequent development of hard drug use and violence. Overall model fit and the magnitude of specific paths were expected to increase across grades. Using structural equation modeling (SEM), results indicated acceptable model fit for 8th-grade (CFI = .95), 10th-grade (CFI = .93) and 12th-grade (CFI = .94) cohorts. Results suggest that the influence of relational victimization and conflict management efficacy on hard drug use may be mediated through low hostile anger control and gateway drug use. Weiner, M.D., Pentz, M.A., Skara, S.N., Li, C., Chou, C.P. and Dwyer, J.H. Relationship of Substance Use and Associated Predictors of Violence in Early, Middle, and Late Adolescence. Journal of Child & Adolescent Substance Abuse 13(4), pp. 97-117, 2004.

School District Personnel Hold the Keys to Implementation of Effective Prevention

An important issue in drug abuse prevention programming is the relative roles of school district and school-level decision-makers in the implementation of effective substance use prevention curricula. Drawing on a "Site-Based Management" approach to effective decision-making, it was hypothesized that schools whose personnel played active decision-making roles would be more likely to implement effective curricula than those in which decision-making was the prerogative of school district personnel. Study data comprised 1,369 questionnaires completed by a representative national sample of both district-level prevention coordinators and middle school-based lead prevention teachers. From the perspective of the lead prevention teachers, the school district-level prevention coordinator was more influential than school staff in selecting effective prevention curricula. However, they did find some support for their hypothesis from the district-level informants, who indicated that community groups and advisory committees also play a modest role in the selection of such curricula. Ringwalt, C., Ennett, S.T., Vincus, A.A., Rohrbach, L.A. and Simons-Rudolph, A. Who's Calling the Shots?: Decision-Makers and the Adoption of Effective School-Based Substance Use Prevention Curricula. Journal of Drug Education 34(1), pp. 19-31, 2004.

Training Youth to Use Leisure Time Wisely Works

The -TimeWise: Learning Lifelong Leisure Skills' curriculum aims to increase positive use of free time, thereby mitigating/ preventing the initiation of substance use. The intervention was delivered to 634 middle school youth in a rural area in eastern United States. Self-report data after one year indicate that students who received TimeWise reported less lack of motivation and more identified and subconscious forms of motivation. TimeWise students reported being better able to restructure boring situations into something more interesting; having higher levels of decision making skills, initiative, community awareness; and participating in new interests, sports, and nature-based activities. Caldwell, L.L., Baldwin, C.K., Walls, T. and Smith, E. Preliminary Effects of a Leisure Education Program to Promote Healthy Use of Free Time. Journal of Leisure Research 36(3), pp. 310-335, 2004.

Infusion-LST Compared to LST as Usual

Findings from the first two years of a study to compare a standard Life Skills Training (LST) program with an infused (I-LST) approach was conducted in 9 small, rural school districts that were randomly assigned to LST, I-LST, or control conditions. Male and female subjects were in grade seven. The LST program significantly reduced alcohol use, binge drinking, marijuana use, and inhalant use after one year for females, and the I-LST program significantly reduced smoking, binge drinking, and marijuana use for females. At the end of the second year the I-LST program continued to impact female smoking, but all other results were non-significant. There were no effects on males at either time point. Smith, E.A. Evaluation of Life Skills Training and Infused-Life Skills Training in a Rural Setting: Outcomes at Two Years. Journal of Alcohol & Drug Education 48(1), pp. 51-70, 2004.

Cost Comparison of LST and Infusion-LST

A cost-effectiveness comparison of the Life Skills Training (LST) to a LST curriculum infusion approach (I-LST) was conducted. Male and female seventh graders from nine rural schools (2 intervention conditions and control) were followed for two years. After one year, significant effects were observed only for females on alcohol, marijuana, and inhalant use in LST condition and for tobacco, alcohol, and marijuana use for I-LST females. After year two, only the I-LST program affected female smoking. Costs for the two programs included actual expenditures for training and materials as well as estimates of teachers' salaries for their project time were calculated. Both programs were almost equally effective after one year, but LST was more cost-effective. I-LST cost more to implement, but sustained effects into year two and was therefore more cost-effective overall. Swisher, J. D. A Cost-Effectiveness Comparison of Two Approaches to Life Skills Training. Journal of Alcohol & Drug Education 48(1) pp. 71-78, 2004.

Effects of Dosage on Outcomes

The present study assessed the ability of the Early Risers "Skills for Success" program to maintain program effects one year post intervention. Participants were kindergarten and first grade children (N=327) who screened positive for aggressive behavior and were randomized to program and control conditions. Program children participated in two continuous years of active intervention followed by one year of no formal intervention activities. Following the active intervention phase, program children, compared to controls, showed significant gains in school adjustment and social competence, but not in academic achievement. At the one-year follow-up program effects were not maintained using intent-to-intervene analyses. Level-of-dosage analyses, however, revealed that there were significant relationships between children's level of participation and measures of their social competence, externalizing problems, and academic achievement. August, G.J., Lee, S.S., Bloomquist, M.L., Realmuto, G.M. and Hektner, J.M. Maintenance Effects of an Evidence-Based Prevention Innovation for Aggressive Children Living in Culturally Diverse, Urban Neighborhoods: The Early Risers Effectiveness Study. Journal of Emotional and Behavioral Disorders 12(4), pp. 2004.

Perceived Life Chances and Alcohol Use

The relationship between low perceived chances for success in life and binge drinking was examined in a sample of economically disadvantaged, predominantly black and Hispanic students, urban adolescents (N = 774) from 13 inner-city schools. Subjects completed confidential questionnaires in the 7th, 8th, and 9th grades. Eight items measured students' estimation of achieving certain adaptive life goals. Students who reported that they typically drink five or more drinks per drinking occasion were identified as binge drinkers. Results indicated that rates of binge drinking increased and perceived life chances decreased for both boys and girls from the 7th to 9th grade. Moreover, higher perceived life chances in the 7th grade predicted less binge drinking in the 8th grade, whereas binge drinking in the 8th grade predicted lower perceived life chances in the 9th grade, controlling for change over time in both variables. Griffin, K.W., Botvin, G.J., Nichols, T.R. and Scheier, L.M. Low Perceived Chances for Success in Life and Binge Drinking among Inner-city Minority Youth. Journal of Adolescent Health, 34, pp. 501-507, 2004.

Self-esteem and Alcohol Use

Prior studies have found inconsistent relationships between measures of self-concept and adolescent alcohol use. This study explored whether the link between various measures of self-concept and alcohol use depends on gender and whether negative rather than positive self-esteem (i.e., self-derogation) might be more useful in predicting alcohol use. Students (N = 1459) attending 22 middle and junior high schools in New York City completed surveys that included measures of efficacy, self-derogation, and alcohol use. Participants completed surveys at baseline, 1-year follow-up, and 2-year follow-up. Findings indicate that lower efficacy was related to greater self-derogation a year later across gender. Increased self-derogation predicted higher alcohol use for girls but not boys. These findings are congruent with a literature highlighting the importance of negative thoughts about the self in drinking behavior for women but not men. Epstein, J.A., Griffin, K.W. and Botvin, G.J. Efficacy, Self-derogation, and Alcohol Use among Inner-city Adolescents: Gender Matters. Journal of Youth & Adolescence 33, pp. 159-166, 2004.

Influence of Parents on Child Anti-social Behavior

This study examined the unique influence of mothers and fathers on their children's antisocial behavior using a sample of 325 families with sixth grade children. Multiple-group comparisons were conducted to identify differences in the relationships for mothers and fathers with daughters versus sons. Results suggested that, while the relationships were often similar for both parents and for both daughters and sons, mothers and fathers uniquely influenced their child's antisocial behavior depending on the child's gender. Overall, cross-gender influence appeared to be particularly important for fathers' control of their daughters' antisocial behavior. Kosterman, R., Haggerty, K.P., Spoth, R. and Redmond, C. Unique Influence of Mothers and Fathers on their Children's Antisocial Behavior: A Social Development Perspective. Journal of Marriage and Family 66(3), pp. 762-778, 2004.

Does Perception of Behavior Affect Behavior?

This research examined whether parents' and children's perceptions have reciprocal self-fulfilling prophecy effects on each others' behavior. Mothers, fathers, and their adolescent children completed self-report surveys and engaged in videotaped dyadic interaction tasks. The surveys assessed parents' and children's perceptions of their own and the other's typical hostility and warmth. Observers coded the videotaped interactions to assess the actual hostility and warmth exhibited by mothers, fathers, and children. Data from 658 mother-child dyads were consistent with the conclusion that children had a self-fulfilling effect on their mothers' hostile behavior, but that mothers did not have a reciprocal self-fulfilling effect on their children's hostility. The data did not support the existence of self-fulfilling prophecies among the mother-child dyads with respect to warmth, or among the 576 father-child dyads for either the hostility- or warmth-relevant data.. Madon, S., Guyll, M. and Spoth, R. The Self-fulfilling Prophecy as an Intra-family Dynamic, Journal of Family Psychology 18(3), pp. 459-469, 2004.

The Importance of Family-based Prevention Interventions in Rural Areas

There are several reasons to promote the implementation of evidence-based family-focused interventions in rural, small town or micropolitan communities. One key reason is research demonstrating that youth problem behaviors are especially prevalent in rural areas and that these problems can be effectively reduced though family-focused programs. For example, studies have found that rural youth are involved in tobacco, alcohol, and illegal substance use at rates that often exceed those of youth living in urban and suburban communities (America's Children, 2000-Federal Interagency Forum on Child and Family Statistics, 2000; National Institute on Drug Abuse, 1997; Johnston, O'Malley, & Bachman, 2000, 2002). Further, earlier program evaluation research has demonstrated the effectiveness of several evidence-based family-focused programs among rural youth, including the reduction of substance use; related economic analyses also have shown that these programs are cost-beneficial. These programs focus on the enhancement of competencies related to reducing risk and increasing protective factors among families and youth. Meek, J., Lillehoj, C.J., Welsh, J. and Spoth, R. Rural Community Partnership Recruitment for an Evidence-based Family-focused Prevention Program: The PROSPER Project, Rural Mental Health 29(2), pp. 23-28, 2004.

Early Identifiers of Later Risk for Depression

This study examined childhood behavior problems at ages 10 and 11 years as predictors of young adult depression, social phobia, and violence at age 21 years. Data were collected on 808 elementary school students from high-crime neighborhoods of Seattle. Reports of childhood behavior problems were obtained from parents and children in fall 1985 and from teachers in spring 1986. Follow-up reports of violence and DSM-III-R depression and social phobia were collected from 765 respondents using standard survey items and the Diagnostic Interview Schedule in 1996. The past-year prevalence of depressive episodes and social phobias were 20% and 17%, respectively. Several available measures of childhood behavior problems as reported by parents, teachers, and children predicted violence; the strongest positive predictor of young adult violence was self-reported conduct problems, whereas self-reported shyness inhibited later violence. Relatively few child behavioral problems predicted social phobia. Results showed that children who reported higher, relative to lower, levels of conduct problems were nearly four times more likely to experience a depressive episode in early adulthood. Mason, W.A., Kosterman, R., Hawkins, J.D., Herrenkohl, T. I., Lengua, L.J. and McCauley, E. Predicting Depression, Social Phobia, and Violence in Early Adulthood from Childhood Behavior Problems, Journal of the American Academy of Child Psychiatry 43(3), pp. 307-315, 2004.